Quadrate lobe focal hot spot sign
Past history of open heart surgery and CV line insertion. Now the patient complains of dyspnea, facial swelling and headache.
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Intensely enhancing area within segment IV which represents the "Hot spot sign". Note a dilated paraumblical vein anterior to the liver.
Superior vena cava obstruction (along its lower portion), with markedly attenuation of its upper segment. Dilated azygous and hemiazygous veins (collateral pathway)
Multiple subcutaneous venous collaterals are seen at the chest wall and anterior abdominal wall.
The lung fields are unremarkable.
Hot spot sign occurs secondary to superior vena cava obstruction and portosystemic venous shunting between the superior vena cava and the left portal vein via the internal mammary and paraumbilical veins along the ligamentum teres.
The focal hepatic hot spot sign can be seen on the Technetium 99m sulfur colloid scans of the liver and spleen as a focal area of increased radiopharmaceutical uptake in the medial segment of the left hepatic lobe (segment IV).
- 1. Elsayes KM, Shaaban AM. Specialty Imaging: Pitfalls and Classic Signs of the Abdomen and Pelvis. Elsevier Health Sciences. (2014) ISBN:0323375456. Read it at Google Books - Find it at Amazon
- 2. Virmani V, Lal A, Ahuja CK et-al. The CT Quadrate lobe hot spot sign. Ann Hepatol. 2010;9 (3): 296-8. Pubmed citation